Methods and instrumentation for disc replacement

Abstract

Various exemplary instruments for introducing an implant using a posterolateral approach are also provided, as well as various exemplary methods for using such instruments. In general, the instruments are configured to interconnect to an implant and/or to a guide member such that the components are all docked relative to one another. This allows the various components of a multi-piece implant to be mated intraoperatively within the disc space, and in particular to be guided into alignment with one another.

1. A method for implanting a spinal implant, comprising:
 manipulating a first inserter tool to position a first component of a spinal disc implant within a disc space between adjacent vertebrae; 
 advancing a second inserter tool along a guide that is coupled to at least one of the first inserter tool and the first component such that a second component mated to the second inserter tool is guided into mating alignment with the first component to thereby mate the second component to the first component; 
 detaching and removing the first inserter tool from the first component, and subsequently advancing a third inserter tool along the guide such that a third component mated to the third inserter tool is guided into mating alignment with the first component to thereby mate the third component to the first component. 
 
     
     
       2. The method of  claim 1 , wherein the guide comprises a guidewire coupled to the first inserter tool, the first component, and the second inserter tool, and wherein the second inserter tool is slid along the guidewire. 
     
     
       3. The method of  claim 1 , wherein the guide comprises a frame coupled to the first inserter tool, and wherein the second inserter tool is advanced through an opening in the frame. 
     
     
       4. The method of  claim 3 , wherein the frame is positioned at least partially outside of the disc space. 
     
     
       5. The method of  claim 1 , wherein the first inserter tool is inserted into the disc space on a posterolateral side of the disc space, and the second inserter tool is inserted into the disc space on a contralateral side of the disc space. 
     
     
       6. The method of  claim 1 , wherein the second component is mated to a lateral side of the first component, and the third component is mated to a contralateral side of the first component. 
     
     
       7. The method of  claim 1 , wherein the first component includes superior and inferior members that are positioned adjacent to superior and inferior endplates of the adjacent vertebrae and that are movable relative to one another. 
     
     
       8. The method of  claim 1 , wherein the second component includes superior and inferior members that are positioned adjacent to superior and inferior endplates of the adjacent vertebrae. 
     
     
       9. A method for implanting an artificial disc replacement, comprising:
 introducing a guidewire into a disc space and positioning the guidewire such that first and second ends of the guidewire are positioned outside of the disc space and a u-shaped portion is positioned in the disc space; 
 advancing a central inserter tool along the first end of the guidewire into the disc space between adjacent vertebrae to position a central component mated to the central inserter tool within the disc space; 
 advancing a first lateral inserter tool along the second end of the guidewire into the disc space to mate a first lateral component mated to the first lateral inserter tool to a first lateral side of the central component. 
 
     
     
       10. The method of  claim 9 , further comprising, prior to inserting the first lateral inserter tool into the disc space, positioning a retaining tool against the central component to maintain the central component in a substantially fixed position and detaching and removing the central inserter tool from the central component. 
     
     
       11. The method of  claim 9 , wherein the central inserter tool is inserted into the disc space on a posterolateral side of the disc space, and the first lateral inserter is inserted into the disc space on a contralateral side of the disc space. 
     
     
       12. The method of  claim 9 , wherein the central inserter tool is used to maintain the central component in a substantially fixed position while the first lateral component is mated to the central component. 
     
     
       13. The method of  claim 9 , wherein the guidewire is introduced into the disc space using a guidewire inserter, and the guidewire is positioned by grasping one of the first and second ends of the guidewire located in the disc space with a grasper, and pulling the grasped end of the guidewire out of the disc space. 
     
     
       14. A spinal implant and instrumentation system, comprising:
 an implant configured to be positioned within a disc space between adjacent vertebrae and having a central component, a first lateral component that is removably matable to a first lateral side of the central component, and a second lateral component that is removably matable to a second lateral side of the central component; 
 a central inserter tool configured to removably mate to the central component; 
 a first lateral inserter tool configured to removably mate to the first lateral component; 
 a second lateral inserter tool configured to removably mate a second lateral component to the central component; and 
 a guide frame configured to removably interconnect the implant, the central inserter tool, the first lateral inserter tool, and the second lateral inserter tool to allow the first and second lateral components to be intraoperatively guided into alignment with and mated to the first and lateral sides of the central component, the guide frame having a first channel adapted to removably receive the central inserter tool, a second channel adapted to removably receive the first lateral inserter tool, and a third channel adapted to removably receive the second lateral inserter tool. 
 
     
     
       15. The system of  claim 14 , wherein the first and second channels on the guide frame are positioned so as to align the central inserter tool with a first lateral side of a disc space and the lateral inserter tool with a contralateral side of the disc space. 
     
     
       16. The system of  claim 15 , wherein the second and third channels in the guide frame are positioned so as to align the first lateral inserter tool and a second lateral inserter tool with first and second opposed lateral sides of the central component. 
     
     
       17. The system of  claim 14 , wherein the central inserter tool is removably matable to the second lateral side of the central component. 
     
     
       18. The system of  claim 14 , wherein the central component includes superior and inferior members that are configured to be positioned adjacent to superior and inferior endplates of the adjacent vertebrae and that are movable relative to one another. 
     
     
       19. The method of  claim 18 , wherein the first lateral component includes superior and inferior members that are positioned adjacent to superior and inferior endplates of the adjacent vertebrae.